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Edmund Tsui, Fei Yu, Gary N Holland; Development of ocular complications in children with chronic anterior uveitis: An analysis of anterior chamber cell and flare. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2067.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the influence of various combinations of anterior chamber cell and flare on development of complications in children with chronic anterior uveitis (CAU).
We performed a retrospective chart review of children with CAU (age ≤16 years at onset) examined by 1 clinician (GNH) from 1993-2008. Mean follow-up was 44.7 mos. (range 0.4-172 mos.). We sought 8 complications: band keratopathy; peripheral anterior synechiae; posterior synechiae; cataract; membranes; glaucoma/elevated intraocular pressure; hypotony; macular edema. Cell was scored with biomicroscopy; flare was measured by laser flare photometry. Low flare was <20 pu/msec; high flare was ≥20 pu/msec. Low cell was <1+; high cell was ≥1+. Statistical analysis utilized Fisher exact test.
Included were 206 eyes (115 children) with CAU. At presentation, subgroups based on inflammation were low flare/low cell (n=31 eyes, 23%); low flare/high cell (n=32, 24%); high flare/low cell (n=10, 8%); high flare/high cell (n=60, 45%). Regarding flare only (excluding those with complications at presentation), incidence of new cataracts during follow-up was significantly higher (p=0.015) in patients with high flare (13/27, 48%) than in those with low flare (7/38, 18%). Pairwise comparisons for new cataracts did not demonstrate differences between combinations of cell/flare, including low flare/high cell (6/23, 26%), high flare/low cell (2/3, 67%), high flare/high cell (11/24, 46%). Pairwise comparisons showed incidence of new glaucoma to be significantly higher (p=0.003) in patients with high flare/high cell (15/40, 38%) than in those with low flare/high cell (1/24, 4%). Glaucoma was more likely (p=0.003) to occur in patients with high flare (15/43, 35%) than in those with low flare (3/42, 7%). Among glaucoma cases in the high flare group, all (n=15) were associated with high cells; only 3 occurred in the low flare group (1 with high cell, 2 with low cell). Other complications had low incidence, with low statistical power to detect differences.
Among children with CAU, both cataract and glaucoma are associated with high flare values. High cell values contribute further to risk of glaucoma in those with high flare. We could not show an effect of cells independent of flare for glaucoma in the setting of low flare or for cataract, likely due to low event rates and imprecision of cell scores.
This is a 2020 ARVO Annual Meeting abstract.
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